TF Gait Deviations/Other Stuff Flashcards
Gait Deviation: Knee Instability
Prosthetic Causes:
- Knee axis too anterior
- Excessive resistance to PF due to too firm PF bumper or stiff heel
- Excessive DF creates flexion moment at knee
- Insufficient Socket Flexion
Patient Causes:
- Weak hip extensor
- Altered height of shoes
- Hip flexion contracture
- Fear
- Weight acceptance too early or with flex knee
- Shorter lever arm of residual limb
Gait Deviation: Lateral Trunk Bending
Prosthetic Causes:
- Prosthetic foot outset
- Too high medial wall
- Abducted socket- pelvic drop sound side- lateral bending
- Insufficient support by lateral socket wall
- Short Prosthesis
Patient Causes:
- Pressure/ pain on lateral distal femur
- Weak hip abductors
- Abductor contracture
- Weak core
- Pain, fear, habit
- Poor balance SLS
Gait Deviation: Wide Walking Gait/Abducted Gait
Prosthetic Cause:
- High medial wall
- Prosthesis too long
- Shank aligned in valgus position with respect to thigh
- Decreased lateral wall support
- Abducted socket- mechanical hip joint
Patient Causes:
- Pain or discomfort in crotch area- adductor roll, skin
- Hip abductor contracture
- Insecurity- fear compensation
- Weak glute medius
Lateral whip
Prosthetic Causes:
- mal-rotation of the knee bolt
- Knee axis in excessive internal rotation
- Improper socket fit
Patient Causes:
- Improper donning of prothesis
- weak flabby musculature rotating around femur (Suction socket)
Medial Whip
Prosthetic Causes:
- Knee axis in excessive external rotation
- Improper alignment of knee bolt
- Improper socket fit
Patient Causes:
- Improper donning of prosthesis
- Weak flabby musculature rotating around femur
Pelvic Elevation/Hip Hiking
Prosthetic Causes:
- Prosthesis too long
Prosthetic knee too much friction
Prosthetic knee extension assist too strong
Patient Causes:
- Habit
- Fear
Pistoning
Prosthetic Causes:
- Inadequate fit or suspension
- May be corrected by auxiliary suspension
Patient Causes:
- Volume Loss
- Insufficient sock Use
Terminal Impact
Prosthetic Causes:
- Inadequate resistance to knee extension or insufficient friction at prosthetic knee
- Too tight/strong extension aid
- Absent or worn extension bumper in knee component
Patient Causes:
- Desiring sensory input to verify knee extension/decreased proprioception
- Excessive forceful knee extension
- Fear of knee buckling
- Gait habit
Uneven Heel Rise
Prosthetic Causes:
- Insufficient friction at the prosthetic knee
- Insufficient tension or no extension aid
- Posterior displacement of the socket
Patient Causes:
- Forceful hip flexion/ excessive hip flexion
- Fear/insecurity
- Bad gait habit
- Gait too fast
Unequal Step Length
Prosthetic causes:
- Socket Flexion inadequate
- Insufficient friction at prosthetic knee or too loose extension aid
Patient Causes:
- Excessive lumbar lordosis
- weak hip extension
- Pain/ insecurity
- Limited hip flexion/extension
- Hip flexion contracture
Exaggerated lordosis
Prosthetic Causes:
- Insufficient socket flexion
- Insufficient Support from anterior socket brim
- Ischial seat too high
- Prosthetists too long
Patient Causes:
- Hip flexion contracture
- weak hip extensors
- Weak abdominal muscles
- Gait habit
- Pain at ischium
Vaulting/Circumduction
Prosthetic Causes:
- Prosthetic too long
- Excessive PF of foot
- Insufficient friction in prosthetic knee-longer time to swing forward
Patient Causes:
- Insecurity or fear
- Weak hip flexors
- Gait habit
- Painful or sensitive residual limb
Foot Slap
- PF bumper too soft
Foot Rotation at Heel Strike
- Too hard heel cushion or stiff PF bumper
- Too much or too little toe out
- medial brim pressure or anterior brim pressure
- Socket too loose
Reduce Arm swing/Trunk Rotation
- Slow gait speed
tight hip rotators
poor weight shifting
Poor forward translation
Pain
Fear
